AIBU to think that there are adults trying to push for an autism diagnosis, that actually have a personality disorder instead?

[surelycantjustbeme]

Someone I know is currently pushing for an adult autism diagnosis. The “autistic traits” she talks about were never present in childhood and seem to have appeared only in adulthood.

From what I’ve read, that pattern can sometimes fit better with something like borderline personality disorder, where there can be a lot of symptom overlap but the difficulties are more tied to relationships, emotions and past environment, and often show more clearly from the teens onwards rather than right through childhood.

I’m posting here because I can’t really talk about this in real life, and I’m genuinely curious whether anyone has come across similar situations. Has anyone seen someone really push the idea that they’re autistic when it doesn’t quite match their history?

For context, this person has always absolutely refused to work or take on any responsibility, and whenever they’re asked to step up, they suddenly lean on “I’m autistic” as the explanation. I obviously can’t diagnose them, but I’m increasingly wondering whether something like a personality disorder might be a closer fit than autism.

Everyone who knows this person knows there have never been any such symptoms in childhood, it's only recently where responsibilities have become a real demand and it's almost being treated as a get out of jail free card.

I know people who have genuinely severely non verbal children, and I also know people who have children with genuine ADHD and are on the spectrum, and the childhood challenges it presents. So please don't read this as me being insensitive in any way.

Am I being unreasonable to think that there could be adults with personality disorders, trying to push for an autism diagnosis instead as it's more widely accepted and better understood.

You do not gain financially from an autism diagnosis. There are 6 with very robust NHS autism diagnoses under multiple services across my family. Only 2 out of the 6 get PIP and that is for additional serious health conditions on top.

Of course these assessments are subjective, and heavily influenced by whatever experience and expectations are held by people who complete it, as well as those who seek it. I don't think these are intentional though, but the professionals should at least have some awareness of their own limitations and bias, and the fact they exist.

Both of which are based on need not just a diagnosis.

Ok thanks, fair point. I hadn’t known the full facts before commenting on the financial aspect. In my case, though, I think the main benefit for the person is that it justifies remaining economically inactive and therefore reliant on others for money, so I do feel there’s a financial motive involved in this situation.

There really is a strict criteria for help. DS with ADHD does not get any extra time in exams. He is allowed a ‘rest break’ but that doesn’t help him so he doesn’t take it.

You're not paying for a diagnosis, you're paying for an assessment

If you are going to a specialist autism centre for an assessment, they are using only assessments designed to pick up/rule out autism. ADOS etc. The are not assessing for anything else. If you were being assessed for personality disorder it would include an assessment called SCIDD, for example.

Psychiatric diagnosis is not simply one single assessment that covers all things in the diagnostic manual and that magically spits out the correct diagnosis at the end. Reaching the correct diagnosis for complex cases can take years, with multiple different types of assessments by multiple-disciplinary teams.

So this idea that if you are being assessed for autism and a possible outcome is the person being told “it’s not autism but it is this instead” is just wrong.

That may happen if you are being assessed by the NHS (good luck with that!) but if you are going to private autism/adhd specialists businesses, they are not assessing you for anything EXCEPT autism and adhd.

At most, they would say you don’t meet the criteria for ADHD/ASD but recommend you seek further assessment from mental health services. That’s it. They cannot diagnose you with anything else because they haven’t assessed you for anything else.’

This is an interesting read (recently published research paper):

‘Increasing self- and desired psychiatric diagnoses among emerging adults: Mixed-methods insights from clinical psychologists’

https://pmc.ncbi.nlm.nih.gov/articles/PMC12804154/

She's describing an adult. As an adult, there are no benefits whatsoever to having a diagnosis if it's not accurate; no support, no financial assistance, nothing. There certainly aren't any upsides to being on the waiting list for an assessment.

It may help in some cases with making the case for a blue badge, but only slightly.

That’s really interesting, thanks for
sharing. I got AI to summarise as I couldn’t read and understand it:

“The study found three main challenges psychologists face:

1. Assessments become harder because clients may answer questions in a way that supports their expected diagnosis.

2. Strong emotional reactions often occur if the final diagnosis doesn’t match what the client hoped for—like distress, anger, or seeking second opinions (“diagnosis shopping”).

3. Extra time and care are needed in feedback sessions, since psychologists must explain outcomes gently and clearly.
   Overall, the study shows that online mental health content and neurodiversity communities have a big influence on how young people think about, label, and seek explanations for their mental health and identity.”

BPD is not an uncontroversial diagnosis in itself.

I couldn’t agree with you more. My concern is that a lot of dissocial personality traits are being ‘forgiven’ in people who seek their justification through autism rather than recognised as problematic and something to be worked on which would be the case with a personality disorder.

I see we've reached the inevitable discussion on whether or not autism should be split into multiple categories or diagnoses. My issue with that is that we've tried it before, and it didn't work.

Where do you draw the line between "high-functioning" and "low-functioning"? Or, to make it even harder, add "mid-functioning" in between them, where I imagine the majority of autistic people fit most of the time?

I was diagnosed in my teens as autistic, but told if I'd been assessed a few years earlier I would be considered to have Asperger's. From an outside perspective I'm verbal (arguably too verbal), I graduated from both school and university, I enjoy travelling by myself, and I have a small but close circle of friends. That said, I still live with my parents, spend most of the day alone in my room to conserve energy, and have violent, self-injurious meltdowns triggered by things like sensory overwhelm, changing plans, or a lack of access to my coping skills. If I begin shutting down or melting down, I can't speak to explain myself. I can't cook proper meals more than a couple of times a week, and even then they're very simple. My diet is pretty limited, and if I can't find a safe-food somewhere then I simply won't be able to eat. If I'm ill, I often need assistance with hygiene. Even when I'm not, showering and baths are a struggle which can tip me over the point of shutdown.

So where would I fit? There have been times in my life when "Asperger's syndrome" almost described me accurately, but far more times that it has not. Like a very articulate PP, it's incredibly ineffective and confusing to describe myself as having Asperger's until something tips me over the line into being autistic. This is the exact reason the diagnoses were combined in the first place- in a lot of cases which diagnosis you received depended on the diagnostician, or how you felt on the day of the assessment. There simply is no clear distinction, not with a dynamic condition such as autism spectrum disorder.

Oh, and for a long time I thought I must have BPD/EUPD because of my struggles with maintaining relationships. It turns out, with therapy, a better understanding of how autism and ADHD affect relationships, and an understanding friend-group of other neurodiverse people, that I now display almost none of the characteristics. It's a really common misdiagnosis amongst autistic people, especially autistic women, and a very stigmatised label to be erroneously stuck with.

It's worth looking into the prevalence of trauma within autistic people. A lot of my BPD/EUPD symptoms were better explained by a combination of autism and ADHD, both of which I was already diagnosed with, and complex trauma from a lifetime of social exclusion and confusion. BPD/EUPD and C-PTSD are often incredibly hard to distinguish, as you may have come across in your own reading. Some researchers have suggested that autism can increase the likelihood of processing events in a "traumatic" way, which in turn can lead to C-PTSD symptoms in people you wouldn't necessarily think had experienced chronic traumatic situations. The National Autistic Society have some interesting information about this:

https://www.autism.org.uk/advice-and-guidance/professional-practice/ptsd-autism

If thats the case I am sure the professionals will pick it up. During my autism diagnosis I was told an ADHD assessment would also be beneficial.

You have never said who this person is to you regardless of if they have any sort condition is it more how it could will affect your life? Maybe it is someone who will expect some sort of support financially or emotionally from you or will they and maybe they already do dominate get togethers.

How abelist can you get! And your evidence for this, given it’s widely known to be the other way round ie autistic women mistakingly diagnosed with BPD?

Can you please explain in detail the use you make of the word ableist as I see you throw it away quite a lot. One of my children is disabled with a neuro motor condition and I have not thrown this term at others like you do.

One presumes your children haven’t been accused of seeking justification for traits of their disability in a diagnosis then.

This does not answer my question. Please clarify how you use this word when criticizing others for ableism. To reassure you, you’re not the only one facing a difficult diagnostic journey; I have been through it too, but I don’t go around labeling others or calling their statements BS, as you do.

I just have. Also incase you’re not aware abelism comes in many forms including:-

• Prejudice & Stereotypes: ( seen aplenty on here )
• Invalidation:
• Questioning if someone is "actually" disabled or making invasive personal inquiries about their condition.

Both autism and BPD are disabilities .

I’ve been accused of being Ableist on here too… I had to look up the definition but I’m really not sure it’s an accurate term that’s being used. As, from what I read:

“Ableism involves harmful attitudes, policies, or behaviors that unfairly treat disabled people as inferior or unworthy of accommodations. This can include assumptions that their lives are less valuable or that they can’t contribute equally to society.”

Isn’t borderline personality disorder classed as a disability too? I really don’t think the definition fits to any of this discussion yet it’s being thrown all over the thread.

It clearly is as per the explanation re how abelsim can present below.

I don't think the OP is being nosey. It's an interesting question.

My daughter got diagnosed age 30 ( shes 33) her son and 3 nephews got diagnosed between age 2 and 6. I always thought she had MH problems.. she went to a special Autism assessment unit every week for six weeks.. l had to fill in loads of forms about her childhood.. l was also interviewed 3 times.. it's not easy.. but she got her diagnosis...even a certificate in case it's needed to show anyone.

What questioning disabilities? Particularly when evidence clearly shows it’s the other way round which clearly doesn’t fit with the OPs goady aim as regards this thread.